


A Consummate Professional

by Cheezalot



Category: Supernatural
Genre: DCSS, Doctor!Cas, Injury, M/M, surgeon!Cas
Language: English
Status: Completed
Published: 2016-01-04
Updated: 2016-01-04
Packaged: 2018-05-11 15:16:05
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 2,711
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/5631223
Author URL: https://archiveofourown.org/users/Cheezalot/pseuds/Cheezalot
Summary: <blockquote class="userstuff">
              <p>Dean/Cas Secret Santa 2016 piece! Prompt: "anything with them being in the doctor/patient dynamic. Doesn't matter who's who."</p>
            </blockquote>





	A Consummate Professional

**Author's Note:**

  * For [Anwamane_13](https://archiveofourown.org/users/Anwamane_13/gifts).



Castiel hated working in the ER, or as it was affectionately nicknamed, “the pit.” No one knew who started it, but the name had been passed around from doctor to doctor so many times that it was just common knowledge that the ER was just “the pit.” Such was his luck that he’d been paged down there what felt like no less than ten times in the last hour. Naturally, it was the squeamish, first-week interns who would rather piss off the head of Ortho than try to set a bone on their own. He liked to think that at one point he’d been intimidating enough that interns wouldn’t page him for nonsense reasons and instead figure out how to do things on their own, but unfortunately that no longer seemed to be the case. First-week intern or no, Dr. Fitzgerald should have been able to set a 30-year-old’s tibia _without help_.

            Setting the tibia patient’s chart on the nurse’s station, Castiel put his head in his hands and sighed.

            The head nurse took the chart from the countertop and filed it appropriately. “What’s wrong, Dr. N? Too many kids in the hospital again?”

            “Always, Ellen. Every year, the new cohort of interns seems younger than the one before,” Castiel paused to yawn, “and I’m reasonably certain the quality of their education is declining as well.”

            “They’re not as stupid as you think, you know. Just give them a chance, and after they get through the ‘error’ portion of trial-and-error, they’ll be less annoying.” Castiel simply raised a disbelieving eyebrow in response. “Seriously! They aren’t! I’ve spoken to most of them, and they’re just scared.”

            Castiel shifted his weight with a sigh. “Fear should not impede their medical skill. Either they are competent or they aren’t.”

            Ellen drew a breath to respond, but something behind Castiel caught her eye and she instead darted around the nurse’s station, grabbing his arm as she went. Instantly on alert, he followed, quickly catching on to what she’d seen. A paramedic and two interns that looked like deer in headlights were running in with a gurney, wheeling in a man whose left foot was pointing up towards his shoulder in a way that feet should never point. The paramedics had packed the foot in gauze as best they could, but as Castiel tagged onto the gurney, directing them into a room, he could see more torn cartilage and broken bone sticking out than he really would have liked to.

            Ellen took the more frightened-looking intern and busied him with getting an IV going and determining the patient’s blood type so they could begin an infusion. The other, whose name Castiel could not remember, came to stand next to him.

            “What can I do, Dr. Novak?”

            Her steady voice got his attention. Castiel did a double take; he was almost surprised that there was an intern who wasn’t terrified at the sight of exposed bone. “Help me remove this gauze. Keep an eye out for bleeders and be gentle—we want to get better visibility without making anything worse.”

            She nodded, focusing intently on the mangled foot she was helping to unwrap. Satisfied that no arteries were pierced—for the moment—Castiel looked up at Ellen. “What’s his name? Were you able to figure out how this happened?”

            “Not yet. He’s in and out, no useful consciousness that I’ve noticed.”

            Castiel sighed. “Fine. We’re admitting him. Call up to the OR, tell them we need the next available room. Dr., um,” he gestured vaguely at the intern unwrapping the man’s foot.

            “Dr. Talbot.”

            “Dr. Talbot, you’ll be scrubbing in on the reparation. Continue cleaning the wound and page me if you have any problems. You,” he pointed to the intern valiantly manning the IV, “get out into the waiting room and find out if this man has any family that accompanied him. If you find anyone, point them in my direction. I want to know how this happened.”

            As Castiel and IV Intern left the room, they were met by a very large man with a very concerned face. Castiel instinctively put a hand on the man’s chest to stop him from entering the room. “Sir, can I help you find someone?” A quick scan told Castiel he wasn’t injured, at least not obviously so.

            The large man ran a hand through his hair. “Um, yeah, I think you were just working on my brother, is he okay?”

            “Can you tell me his name, sir? You understand that I cannot release any patient information to someone who is not family.”

            “Oh, uh, yeah, his name is Dean Winchester, I’m his brother, Sam. Is he okay?” Sam tried to look into the room through the window behind Castiel. “He’s not moving.”

            “Your brother is fine, Sam. Would you like to go have a seat and I can update you on his condition?”

            Castiel could tell Sam would much rather go inspect his brother for himself, but clearly understood that Castiel’s posture and hand on his sternum wouldn’t let that happen. Instead of pushing through, Sam nodded, turning and following Castiel to the waiting area. IV Intern, who had been standing silently and trying not to appear too unnerved by Dean’s mangled foot, slipped away to find another assignment.

            “I’m Dr. Novak, and I’ll be your brother’s attending doctor until he is well enough to be discharged. One of our interns, Dr. Talbot, is currently working with our head nurse to examine and clean your brother’s foot as best they can before we take him up to surgery.” Sam’s face fell at the mention of surgery. “Can you tell me how this happened? The damage is quite extensive.”

            Sam swallowed. “Hunting accident,” he answered brusquely.

            “Your brother was shot?”

            “No, um, a bear got to him. We were hunting and accidentally shot at a, um, a bear cub. The mother wasn’t too happy and grabbed him by the foot. She tried to drag him away, but I, uh, I took care of it and she let him go.”

            Castiel tilted his head, not quite convinced Sam was telling him the whole truth, but he couldn’t deny that Dean’s foot looked like it had been mangled by a large animal. Sam leaned back apprehensively, as if he were anticipating Castiel’s apprehension.

            “Was the animal venomous?”

            “No, it wasn’t.” Sam breathed a sigh of relief at Castiel’s simple question.

            “Good. We will do everything in our power to restore your brother’s foot. I will be able to provide you with more information as to his prognosis once surgery is over. Please do remain calm and in the waiting area; this is not a life-threatening injury, but it is severe.” With a practiced, comforting smile, Castiel left to check on his patient, as well as Dr. Talbot’s progress.

~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~

            A few days later, Castiel was still thinking about the mysterious foot injury he’d reconstructed with Dr. Talbot. She had performed admirably, asked insightful and appropriate questions, and, when given the opportunity, stitched tissue together very skillfully for an intern with her field experience. Even though it seemed clear to Castiel that a bear grabbing Dean’s foot would not have caused the amount of damage that was present, Dr. Talbot didn’t comment, and Castiel didn’t push Sam for more information, as it wasn’t relevant to the treatment of his patient.

            The surgery had gone about as well as Castiel could have expected. With exposed, broken bone and cartilage, it was tricky to tell how much reconstruction could be done effectively. When they had closed and bandaged the foot, Castiel guessed that Dean would have roughly 80% range of motion once healed, but in his post-operative checks, it seemed that he would regain up to 95% of his original range of motion. As he explained to Dean, as long as excess weight and stress was kept off the joint, and it wasn’t bent in any unnatural fashion (or stretched unduly), there shouldn’t be any major trouble once it had healed properly.

            However, as Castiel was quickly becoming aware, keeping Dean Winchester in bed to heal for the requisite ten weeks was not going to be easy.

            One week after surgery, still in a plaster cast, Dean was trying to get up and walk around the room unassisted. Castiel had overheard more than one nurse complaining about how Dean seemed determined to tear his stitches and reopen the wound. Ellen had paged him to her station once just to ask if he would go in and, as she put it, “put the fear of God into that fool” to dissuade him from behaving against medical advice. Castiel had refused, insisting that once Dean felt the pain from walking on a broken and torn ankle, he would learn.

            Two weeks after surgery, Dean still hadn’t learned, and was healing more slowly than expected as a result. Regardless of his progress, Castiel was insisting that the other Dr. Novak, Castiel’s brother Balthazar, do an initial physical therapy assessment as if Dean was healing on schedule.

            “No, Cassie, I don’t think it’s a good idea. Starting physical therapy on an insufficiently healed bone can have detrimental effects in the long run, and I know you know that’s true. So why do you really want me going in there as if this idiot had stayed in bed like you suggested?” Balthazar crossed his arms, sitting back against the conference table in the room they’d stepped into for privacy.

            “I don’t want you to actually start therapy on him. The reason he’s not healing on schedule is because he’s refusing to remain in bed. I want you to do an initial assessment based on where he is now, and inform him of the risks of continuing on as he has been. Hearing these things from the doctor who fixed him is different than the doctor that he’d be working with for an extended period of time to be able to walk again. I want you to help me, as Ellen put it, ‘put the fear of God’ into him so he will heal correctly an on schedule.”

            Balthazar chuckled. “Gotcha, so you want me to go in there with you and play bad cop. Works for me.” He slapped his clipboard with Dean’s chart on it against Castiel’s arm. “Let’s go see your foot patient.”

~*~*~*~*~

            With a cursory knock on the door, Balthazar walked into Dean’s room with a flourish, shaking his hand before coming to stand at the end of the bed next to Castiel.

            “Pleasure to meet you, Mr. Winchester. I’m Dr. Novak, this is also Dr. Novak, my brother. I am going to be your physical therapist, and he’s the one that put your foot back together after that nasty bear tore it to bits.” Balthazar gestured to either himself or Castiel when appropriate. Castiel simply stood quietly, hands at his sides, and watched Dean’s reactions to Balthazar.

            Dean looked confused. “Physical therapist? I thought the nurses that were in here said I wasn’t even supposed to be out of bed yet.”

            The irony of his objection wasn’t lost on either of them. “I’m surprised you heard that. From what I understand, you haven’t listened to anything else they’ve been telling you.” Balthazar raised an eyebrow at him.

            Dean grinned, waving a hand dismissively. “Yeah, well, you know nurses, man, all the ones I’ve met worry too much.”

            Both Dr. Novaks simply stared at him.

            “Okay, fine,” he conceded. “I know I’ve been taking some liberties with my post-op instructions, or whatever you call it, but it’s because I’m feeling up to it. Just ask them, I’ve been making it to and from the bathroom all on my own, just like a big boy.”

            “Just because you _can_ doesn’t mean you _should_ , Mr. Winchester. I don’t know if Cassie here has told you,” Balthazar gestured to Castiel, ignoring the glare he was receiving for his unprofessionalism, “but your foot is being held together by about a hundred stitches and not an insignificant amount of faith in your ability to not tear it all open again. Putting weight on it and using it before _it_ is ready can do a lot more harm than you are able to feel now, especially in the long run.”

            “I hear you, I do, but seriously, guys, take it easy, I’m practically good as new already, watch!”

            As Castiel and Balthazar watched, tensed to intervene, Dean swung his legs off the side of the bed and stood up slowly, all the while maintaining his overconfidence. When he was successfully upright for a few seconds, he grinned at them. The undertone of “told you so” was not lost on Castiel, but he only had a few moments to think about it before Dean’s injured foot evidently gave out—Dean suddenly pulled it off the ground and his body, not used to standing, couldn’t balance on the one. On instinct, Castiel darted under Dean’s arm, holding his forearm with one hand and wrapping the other around his waist to help support him.

            _If I were not a consummate professional, I’d probably be distracted by this. Good thing I’m definitely not. Distracted, I mean._

“This is what we were talking about,” Castiel remarked as he helped (more insisted than assisted) Dean to lie down again. “You may have moments of functionality from time to time that feel normal, but unless you stay off that foot until Dr. Novak clears you to walk unassisted, I can assure you that this behavior will make your recovery more difficult. If I have to operate on you again, I can’t guarantee you won’t lose mobility or use of your foot altogether.”

            Dean chuckled, but there was an underlying layer of concern and pain this time. “C’mon, fellas. I get that it’s gotta heal, but ten weeks off my feet and then however more long for physical therapy? That’s a really fucking long time. My brother and I, we’ve got a business we gotta get back to, and I can’t let him do it alone for that long.”

            Balthazar broke in with what was supposed to be a calming tone. “We understand, Mr. Winchester; everyone has responsibilities they have to get back to, but this is your mobility in question here, and—”

            “Dean,” Castiel interrupted, voice stern, “if you do not do as you’re told, you could lose your foot. I might have to cut it off of you if you don’t follow my directions exactly.” He saw the fear in Dean’s eyes at the mention of amputation. “Do as I ask and you will be fine. Continue this reckless behavior and you will not be. Understood?”

            “Understood,” Dean nodded. “Do what you say and I get to keep my foot.”

            Castiel nodded, pleased, and abruptly turned to leave the room, assuming Balthazar would follow now that their task was complete.

            When they were out of earshot of Dean’s room, Balthazar stopped him. “Cas, wait, what the hell was that? ‘Dean’?” He tried to imitate Castiel’s gravelly voice.         

            “It worked, didn’t it?” Castiel tried to shrug him off, but Balthazar darted in front of him, blocking his way.

            “What, don’t tell me you got in there, saw that pretty face, and threw the game plan out the window. Thirty minutes ago you wanted it to come from the physical therapist, then you go and interrupt me when I try to do my job!” Castiel kicked himself for stiffening at Balthazar’s accusations, and then kicked himself again when he saw Balthazar’s knowing smile. “And you sneered at _me_ for being unprofessional. At least I didn’t start fawning over a patient after feeling him up.” He laughed. “I’ll take him. As of right now he’s on my rotation, not yours, as long as you take him to dinner when he’s mobile again.”

            Castiel tried to fight the blush that was threatening to heat his ears, but Balthazar’s shit-eating grin told him he was not successful. After staring at each other for a few moments, Castiel seething and Balthazar grinning widely, unperturbed, Castiel grated out a curt “fine” before pushing past Balthazar and telling himself that this definitely didn’t make him any less of a professional.

            Besides. Dean wasn’t technically his patient anymore.

**Author's Note:**

> There is a follow-up in the works. This was all I could get done by the deadline (class gets in the way). I can't wait to see where these nerds take me ;)


End file.
